Husband stubborn about hearing

Updated 5:25 pm, Friday, January 31, 2014

Q: My husband is acting quite unreasonable lately and I think I may need your help. We are a healthy couple aging successfully together. We are very physically active and enjoy playing sports and dancing. About two years ago, I noticed that my husband had some trouble hearing me, especially in a group of people. He got a hearing test and the doctor recommended hearing aids. This is when the problems started. As hearing aids are expensive and insurance does not cover them, my husband decided against getting them. Now things are so much worse. He is starting to isolate himself and does not want to go out as much. At dances, he struggles. This is all while insisting that he is OK without the hearing aids. I know that he is not. Maybe you will be able to convince him. I just want him to stay active and enjoy his life.

Nancy

A: We all know that it is never easy to argue with a spouse. Having said that, I hope that I can try to convince Nancy's husband to get help with his failing hearing. But first, let's review how we hear sounds and what causes hearing loss.

Our ear has three parts -- the external, or outer, piece, the middle ear and the inner ear. Sound travels as a wave through the air. That is why very loud sound can actually cause vibrations.

When a sound wave reaches the ear, it first gets to the outer part and then to the ear drum. The drum captures the vibration of the wave. Next, it gets it to the middle ear. There we have three little bones known as the hammer, anvil and stirrup.

These tiny bones amplify the vibration of the sound and, in turn, pass it to the snail-shaped inner ear structure known as the cochlea. The cochlea has fluid inside and its walls are full of tiny hairs connected to nerve cells. The cells receive different electrical signals depending on the type of sound and the sound wave agitating the hairs. The brain's hearing center then receives the signals and makes sense of them based on prior experiences.

When we age, the quality and number of the hairs inside the cochlea deteriorate. About one third of people 65 to 75 have some hearing loss and roughly half of those 75 and older are hearing impaired in some way.

There are also other reasons for hearing loss than aging. There is a clear relationship between exposure to loud noise and hearing loss. Excessive wax buildup can also be a hearing loss culprit and can be easily dealt with. Ear wax it is a little bit like with sweating -- some people have a lot of it and others do not. One should not remove ear wax by digging into the ear with a cotton swab -- this is when seeing a specialist for proper cleaning is an absolute must.

Other reasons for hearing problems include ear infections or other infections, such as mumps, measles, meningitis and certain autoimmune problems. The sexually-transmitted disease syphilis and chlamydia in a pregnant woman can result in deafness of a newborn child. HIV infection also can cause hearing loss.

There is also a disease that runs in families called otosclerosis. This is when one of the three bones in the middle ear -- the stirrup -- becomes hardened and stops vibrating and conducting sound waves.

Medications from many different groups can be responsible for hearing impairment as well. Some antibiotics are on that list, as well as antimalarial drugs, some water pills and cancer fighting drugs. The list even includes some drugs used for erectile dysfunction. As with all medication-related problems, the first step is to tell your primary care doctor about your suspicions and ask for a review of your medications.

The early signs of hearing loss include not being able to follow a conversation in a crowded room, cranking up the TV and difficulty conversing on the phone. When our friend, loved ones, and, especially, our doctor tell us to get checked, it needs to be taken seriously. Audiology testing can help determine the severity of hearing loss and whether hearing aids would help. The test uses sounds of different frequency are used to "map" our hearing ability. Most hearing loss associated with aging starts with higher pitch tones. Depression, anxiety, a sense of isolation and withdrawing from social activities have all been described as a consequence of unaddressed hearing loss.

In studies, people who did get hearing aids all reported better relationships with loved ones, renewed self confidence and an improved outlook on life.

I do realize that cost is of concern. Hearing aids can be very expensive. But one should really look at them as a longer term investment -- just like getting a reliable car or a computer. Some people do try cheaper, store-bought amplifiers and are happy with them. I think that is an option, especially if cost is a big issue. I also think that, if hearing loss is present on both sides, the best way to deal with it is to get bilateral hearing aids. The newest hearing aids are truly impressive electronic devices. They can be customized, programmed to extinguish buzzing noises, implement soothing sounds to help one sleep and even alert the owner when the battery needs to be changed.

It is very clear to me that something has changed with Nancy's social life. For a couple this outgoing and vibrant it would be a shame to lose it all. Physical and mental activity -- especially dancing -- has been shown to have numerous benefits, including helping fend off memory loss. If you think you or a loved one has a hearing problem, pursue testing and get hearing aids if you can.